Attention-Deficit Hyperactivity Disorder

Neither sibling was having any apparent problems. Mrs… Wilson had a full-term pregnancy with Ken. The delivery was without complication, although labor was fairly long. According to his parents, Ken’s current problems began in kindergarten. His teacher frequently sent notes home about his disciplinary problems in the classroom. In fact, there had been concerns about promoting Ken to the first grade. The final result was a “trial promotion. ” Everyone hoped that Ken would mature and do much better in first grade, but his behavior became even more disruptive.

Ken’s mother had received negative reports about him from his teacher several times over the first 2 months of school. His teacher reported that he didn’t complete his work, was disruptive to the class, and behaved aggressively. Ken’s parents described him as a difficult infant, much more so than his older sister. He cried frequently and was described as a colicky baby by their pediatrician. He did not eat well, and his sleep was often disturbed and restless. As Ken grew, his mother reported even more difficulties with him. He was into everything.

Verbal reprimands, which had been effective in controlling his sister’s behavior, seemed to have no effect on him. When either aren’t tried to stop him from doing something dangerous, such as playing with an expensive vase or turning the stove off and on, he would often have a temper tantrum that included throwing things, breaking toys, and screaming. His relationship with his sister was poor. He bit her on several occasions and seemed to take delight in trying to get her into trouble. His parents described a similar pattern of aggressiveness in Ken’s behavior with the neighborhood children.

Many of the parents no longer allowed their children to play with Ken. They also reported that he ad low frustration tolerance and a short attention span. He could not stay with puzzles and games for more than a few minutes and often reacted angrily when his brief efforts did not produce success. Going out for dinner had become impossible because of his misbehaving in restaurants. Even mealtimes at home had become unpleasant. Ken’s parents had begun to argue frequently about how to deal with him. School records generally corroborated his parents’ description of Ken’s behavior in kindergarten.

His teacher described him as being “destructible, moody, aggressive,” and a “discipline problem. Toward the end of kindergarten, his intelligence and academic achievement were tested. Although his IQ was placed at interview with Ken’s first-grade teacher provided information that agreed with other reports. Ken’s teacher complained that he was frequently out of his seat, seldom sat still when he was supposed to, did not complete assignments, and had poor peer relations. Ken seemed indifferent to efforts at disciplining him.

Once while being in the class, he Jumped up to look out the window when a noise, probably a car backfiring, was heard. He went to talk to other children several times. Ken got up wise and Just began walking quickly around the classroom. Even when he stayed seated, he was often not working and instead was fidgeting or bothering other children. Any noise, even another child coughing or dropping a pencil, distracted him from his work. When his teacher spoke to him, he did not seem to hear; it was not until the teacher had begun yelling at him that he paid any attention.

The pattern that had begun earlier in Ken’s childhood continued. He still got along poorly with his sister, had difficulty sitting still at mealtimes, and reacted with temper tantrums when demands were made of him. His behavior had also taken on a daredevil quality, as illustrated by his climbing out of his second-story bedroom window and racing his bicycle down the hill off heavily trafficked local street. Indeed, his daring acts seemed to be the only way he could get any positive attention from his neighborhood peers, who seemed to be mostly afraid of him. He had no really close friends.

Mrs… Wilson hinted that she and her husband had marital problems. When this was brought up directly, she agreed that their marriage was not as good now as it once had been. Their arguments centered on how to handle Ken. Mrs… Wilson had come to believe that severe physical punishment was the only answer. She described an active, growing dislike of Ken and feared that he might never change. Mr… Wilson child-rearing philosophy was somewhat more of a “boys will be boys” approach. In fact, he admitted that as a child, he was like Ken. He had “grown out of it” and expected Ken would, too.

As a result, he let Ken get away with things for which Mrs… Wilson would have punished him. The couple’s arguments, which had recently become more heated and frequent, usually occurred after Mr… Wilson had arrived home from work. Mrs… Wilson, after a particularly exasperating day with Ken, would try to get Mr… Wilson to discipline Ken. “Just wait until your father gets home” was a familiar refrain. But Mr… Wilson would refuse and accuse his wife of overreacting; the battle would then begin. On one occasion at home, Ken and his sister got into a fight over who was winning a game.

Ken broke the game, and his sister came crying to her mother, who began shouting at Ken. Ken tried to explain his behavior by saying that his sister had been cheating. His mother ordered him to his room; shortly thereafter, when she heard him crying, she went up and told him he could come out. At dinner, the meal began with Ken complaining that he did not like anything on his plate. He picked at his food for a few minutes and then started making faces at his sister. Mrs… Wilson yelled at him to stop making the faces and eat his dinner. When she turned her back, he began shoving food from his plate onto his sister’s.

As she resisted, Ken knocked over his glass of milk, which broke on the floor. Ken’s mother was enraged at this point, but she calmed herself, and she told Ken that he would be in big trouble when his father got home. When Mr… Wilson came home, he made light of the incident and refused to punish Ken. Ken met the criteria for Attention-DefIcit/Hyperactivity Disorder (ADD) in the Diagnostic and Statistical Manual of Mental Disorders (ADSM IV-TRY; PAP, 2000). ADD is one of the subcategories in the manual’s section headed “Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence. Attention-deficit/hyperactivity disorder mirrors the fundamental view that problems with attention are the principal aspect of the disorder. These difficulties include failure to finish tasks, not listening, being easily distracted, and having problems concentrating and maintaining attention. This description fits Ken well. Overcapacity and restlessness were reflected in his problem staying seated in school, fidgeting when seated, and being described as “always on the go. ” Hyperactivity is especially evident in any situation that requires controlling an activity level, such as school and mealtimes.

ADSM IV-TRY (PAP, 2000) listed three types of ADD: (a) The primarily inattentive type in which poor attention predominates; (b) The predominately hyperactive type in which hyperactivity and impulsively are primary; and (c) The combined type in which both hyperactivity and inattention are prominent. According to the manual, Ken’s can be diagnosed with ADD, combined type, because he met the criteria for both the inattention and hyperactivity components. Additionally, Ken shows a number of other difficulties, such as poor performance at school and difficulties in getting along with peers and making friends.

He also ignores safety precautions by taking risks and doing daring activities (e. G. Climbing out of his second-story bedroom window and racing his bicycle down the hill of a heavily trafficked local street). Ken’s symptoms of ADD first appeared during toddlers and continued in school age. Ken has met the diagnostic criteria because his hyperactivity-impulsively is present in two settings – at home and in school, which interfere with his developmentally appropriate functioning socially, academically and in his extracurricular activities.

According to Wisped, the cause of most cases of ADD is unknown, however, it is believed to involve genetic factor. In this case, it is said that Ken’s father also had similar patterns of behavior during childhood, which he had outgrown. Although environment can also play an important factor in developing the disorder, it was not aid if the mother had prenatal toxic exposures. It is also important to note the quality of parent-child relationship. The parent-child relationship is bidirectional wherein the behavior of each is determined by the actions and reactions of the other.

For example, Ken’s mother seems to give him more commands and mostly has negative relations with him, Ken in this case shows less compliance (unless being yelled to) and has a more negative interactions with her mother (showing tantrums). Other suggested contributory factors for ADD include prematurely and other reposed as possible causes of hyperactive behavior; however, there is no scientific evidence indicated that these factors cause ADD. Theoretical Perspective: The best suited theory that can be applied in this case is the Diathesis-stress Theory by Bruno Bethlehem (1973).

Bethlehem suggested that hyperactivity develops when a predisposition to the disorder is coupled with authoritarian upbringing by parents. It also discussed in this theory that if a child with a disposition toward over- activity and moodiness is stressed by a mother who easily becomes impatient and essential, the child may be unable to cope with the mother’s demands for obedience. As the mother becomes more and more negative and disapproving, the mother-child relationship ends up as a battleground.

With disruptive and disobedient pattern established, the child cannot handle the demands if school and his behavior are often in conflict with the rules of the classroom. Another theory that explains the occurrence of ADD is the Social Construction Theory. It argues that attention deficit hyperactivity disorder is not necessarily an actual disorder, but that an ADD diagnosis is a socially constructed explanation to ascribe behaviors that simply don’t meet the prescribed social norms.

Some proponents of the social construct theory of ADD seem to regard the disorder as genuine, though over-diagnosed in some cultures. These proponents cite as evidence that the ADSM IV, favored in the United States for defining and diagnosing mental illness, arrives at levels of ADD three to four times higher than criteria in the ACID 10, the diagnostic guide favored by the World Health Organization. A popular proponent of this theory, Thomas Sass, has argued that ADD was “invented and not discovered. ” (Wisped).

Social construct theory suggests that societies especially the western, creates pressure on families. In return, these families will then blame environment as the primary factors that cause ADD in children. The theory also believes that the parents who failed on their parenting responsibilities will use the ADD label to be freed from guilt and self-blame. Psychological Assessments: Some of the basic personality tests can be very useful in determining this disorder: Draw-A-Person Test (ADAPT) > impulsively can be seen if a child draws a picture that cannot be contained on one sheet of paper and goes off the page.

House-Tree-person Test (HTTP) > test results could give information concerning the condition of the child’s domestic situation – if the child draws a big house, it means that the child has strong conflict with the people at home; while the trunk of the tree Children’s Apperception Test (CAT) > card#l and card#IBM will show the child’s attitude towards his parents – either the child has compliance or conflict with them.

Bender Visual Motor Gestalt Test (BOMBS) > this test can be used to evaluate “visual- motor maturity” of the child and to screen for developmental disorders; also used to sees neurological function or brain damage. Therapeutic Approach: Operant Conditioning can be deemed fit in treating ADD. This therapy can be successful in improving both social and academic behavior of the child. In this treatment, children’s behavior is monitored at home and in school, and they are reinforced for behaving appropriately, for example, for remaining in their seats and working on assignments.

Point systems and start charts are typical components of these programs. Youngsters earn points and younger children earn stars for behaving in certain ways; the children can then spend their earnings for rewards. The focus of the Operant Program is on improving academic work, completing household tasks, or learning specific social skills, rather than on reducing signs of hyperactivity, such as running around and Jiggling. Although hyperactive children have proved responsive in this Operant Program, the optimal treatment for the disorder may require the use of both stimulants, (e. . Rattail or methamphetamine; prescribe for ADD since the early sass’s; the stimulating effects of these drugs calm ADD children and improve their ability to concentrate. ) and behavior therapy. Prevalence in the Philippines: ADD is more prevalent in boys than in girls, with the ratio ranging from 2 to 1 to as much as 9 to 1 first degree biological relatives. Below is a statistics of ADD that were taken from an article in ABS-CB website, current affairs program, Salaams Doc: ADD Kulaks as Pains, by Yam deal Cruz, (2012). 0% of adolescents have the symptoms 60% of adults show the symptoms 40%-50% of children with ADD have learning disabilities 30%-50% of children with ADD engage in disorderly conduct and exhibits signs of anti-social behavior 35% of children with ADD do not finish high school 25% of children with ADD oftentimes fight with other kids 0% to 25% of children experience hyperactivity 3-5% of the world population has ADD American Psychiatric Association (2000).